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Sixth hour transcutaneous bilirubin predicting significant hyperbilirubinemia in ABO incompatible neonates
Ramesh Y Bhat, Pavan CG Kumar
Manipal, India
Author Affiliations: Department of Pediatrics, Kasturba Medical College, Manipal University, Manipal-576104, Udupi District, Karnataka, India (Bhat RY, Kumar PCG)
Corresponding Author: Ramesh Y Bhat, Department of Pediatrics, Kasturba Medical College, Manipal University, Manipal-576104, Udupi District, Karnataka, India (Tel: 91 9448296564; Fax: 91 820 2571927; Email: docrameshbhat@yahoo.co.in)
doi: 10.1007/s12519-013-0421-5
Background: Neonates with ABO hemolytic disease are at greater risk for developing significant hyperbilirubinemia. We aimed to determine whether sixth hour transcutaneous bilirubin (TcB) could predict such a risk.
Methods: TcB measurements were obtained at the 6th hour of life in blood group A or B neonates born to blood group O, rhesus factor compatible mothers. Subsequent hyperbilirubinemia was monitored and considered significant if a neonate required phototherapy/exchange transfusion. The predictive role of sixth hour TcB was estimated.
Results: Of 144 ABO incompatible neonates, 41(O-A, 24; O-B, 17) had significant hyperbilirubinemia. Mean sixth hour TcB was significantly higher among neonates who developed significant hyperbilirubinemia than those who did not (5.83¡À1.35 mg/dL vs. 3.65¡À0.96 mg/dL, P<0.001). Sixth hour TcB value >4 mg/dL had the highest sensitivity of 93.5% and >6 mg/dL had the highest specificity of 99%. Area under receiver operating characteristic curve was 0.898.
Conclusion: Sixth hour TcB predicts subsequent significant hyperbilirubinemia in ABO incompatible neonates.
Key words: ABO incompatibility; neonate; phototherapy; significant hyperbilirubinemia; transcutaneous bilirubin
World J Pediatr 2014;10(2):182-185
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